Autologous Limbal Stem Cells Transplantation And Amniotic Membrane Transplantation In A Patient After Thermal Burn From Fireworks

Purpose of this article is to present a case report of an autologous limbal stem cells transplantation to a patient with a total thermal burn of the corneal and 90% of the palpebral and bulbar conjunctiva caused by fireworks. 

 

 

Male patient, 47 years old, attended the Emergency Unit of the Ophthalmology Department in University General Hospital of Heraklion for a total thermal burn of the left eye caused by fireworks. From the clinical examination of the left eye the visual acuity was UCVA: 3/10, intraocular pressure IOP: 16,7mmHg and he presented a total defect of the cornea and 90% of the palpebral and bulbar conjunctiva. 

 

 

He was treated with topical and systemic corticosteroids to control the inflammation, prophylactic topical antibiotics and hydration for inducing epithelialization. The patient responded partially to the treatment, but then corneal conjunctivalization and onset of conjunctiva scar was introduced due to ischemia. Clinically significant deficiency of limbal stem cells was recognised and was followed by decrease of the visual acuity. We made the decision to do a limbal autologous stem cells transplantation from the fellow eye and amniotic membrane transplantation in the same session. Tarsorrhaphy of the left eye was performed after the transplantation for the stability of the transplants. Three weeks postoperatively the visual acuity was UCVA 10/10, at the slit lamp examination we noticed total epithelialization of the cornea and conjunctiva. The entropion of the upper eyelid due to symblepharon that occured after the thermal burn was treated with therapeutic contact lens until blepharoplasty procedure that was performed two months later. Nine months after treatment the visual acuity remains UCVA:10/10.